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Organization

CLOVE LAKES REHABILITATION AND OUTPATIENT SERVICES

Active
Parent organization
CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC.
Authorized official
MARY BETH FRANCIS (ADMINISTRATOR)
(718) 289-7034
Entity
Organization

Contact information

Practice address
25 FANNING ST, STATEN ISLAND, NY 10314-5307
(718) 289-7878
Mailing address
25 FANNING ST, STATEN ISLAND, NY 10314-5307
(718) 289-7890
(718) 761-8701

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01876104
NY
Enumeration date
06/13/2006
Last updated
07/17/2007
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